Effects of Levetiracetam and Sulthiame on EEG in benign epilepsy with centrotemporal spikes: A randomized controlled trial

PURPOSE

BECTS (benign childhood epilepsy with centrotemporal spikes) is associated with characteristic EEG findings. This study examines the influence of anti-convulsive treatment on the EEG.

METHODS

In a randomized controlled trial including 43 children with BECTS, EEGs were performed prior to treatment with either Sulthiame or Levetiracetam as well as three times under treatment. Using the spike-wave-index, the degree of EEG pathology was quantified. The EEG before and after initiation of treatment was analyzed. Both treatment arms were compared and the EEG of the children that were to develop recurrent seizures was compared with those that were successfully treated.

RESULTS

Regardless of the treatment agent, the spike-wave-index was reduced significantly under treatment. There were no differences between the two treatment groups. In an additional analysis, the EEG characteristics of the children with recurrent seizures differed statistically significant from those that did not have any further seizures.

CONCLUSION

Both Sulthiame and Levetiracetam influence the EEG of children with BECTS. Persistent EEG pathologies are associated with treatment failures.

[Clinical aspects and problems of cytomegalovirus infections in newborn and premature infants]

Describing the course of illness of six newborn infants suffering from connatal respectively postnatal acquired cytomegalovirus infection most important problems of this disease during neonatal period are discussed. There are reviewed: questions according diagnostic specificity of CMV-infection in the newborn; neurologic and sensorineural sequelae; the influence of prematurity and immune deficiency on the severity of the disease; possibility of chemotherapy against CMV and; the morbidity of preterm infants following postnatal, especially transfusion-associated CMV-infection.

[Studies on manifestations of Rh-related hemolytic disease of the newborn in the years 1974-1989 in the Erfurt district]

In the course of 13 years (1977-1989) 223 of 223,121 liveborn infants in the district of Erfurt suffered from haemolytic disease due to Rh-isoimmunization, 0.1 per cent died. An initial drop of morbidity from 1.6 to 0.6 of 1000 newborns was followed by stagnation and further increase during the last years. More than 50% of the affected babies were delivered by women who had to be protected from sensibilization by immune prophylaxis. The cause for the immunization were deliveries (75%), miscarriages and interruptions (23%). The most important reason for the insufficient decrease of the Rh-morbidity is the failure of immune prophylaxis in the case of ABO-incongruence between mother and child. Our results support the demands for a general immune prophylaxis without taking into consideration the main blood groups and the number and result of the pregnancy. The quantity of severe erythroblastosis (7 stillborn and 5 hydropic liveborn) demonstrates the necessity to improve the prenatal management of these babies.

[Serum concentration of gentamicin in newborn infants]

Serum levels of gentamicin were determined in 15 premature infants (birth weight 1,120-2,250 g, gestational age 27-36 weeks) by agar immunoassay. The intramuscular applied doses was 6 mg/kg/day, the doses interval 12 hours. We found an increase of the gentamicin serum level during the first 72 hours after the beginning of therapy. At the second day of treatment the serum levels in 46.5% of all patients were determined below the therapeutic concentration, but a toxic level was found in more than 60% of all cases during the period of steady state. The serum levels were higher in preterm newborns of less than 1,500 g birth weight, then in more mature infants. We recommend: 1. To double the first doses of gentamicin 2. To modify the gentamicin level by expanded intervals of therapy and/or reduced doses under monitoring, especially during the first week of life.

[Three years of CPAP-breathing therapy in immature and mature newborns (author's transl)]

162 immature and mature asphyctic newborns were treated by CPAP breathing. The overall survival was 42%. Taking babies without primary asphyxia not into account, 55% per cent survived. On children born before the 34. week of gestation, the therapeutic effectivity decreased markedly.

[Neuropediatric follow-up studies of preterm born babies with birth weight below 1600 g (author's transl)]

Neuropediatric follow-up studies during 18 months of preterm born babies with birth weight below 1600 g show a normal development in 70%. Better perinatological and neuropediatric long-term care are taken as causes of the improved developmental prognosis of children at risk in recent years.